Reasons for and functional results of repeated hip arthroscopy: A continuous prospective study of 17 revisions out of 295 primary hip arthroscopies at mean 28 months’ follow-up

Tissot, Claire; Merlini, Lorenzo; Mercier, Marcelle; Bonin, Nicolas

doi:10.1016/j.otsr.2017.04.002

Cited by 8 publications

(6 citation statements)

References 36 publications

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Section: Resultsmentioning

confidence: 99%

“…Six of the included studies compared primary to revision hip arthroscopic surgery, 6,13,14,17,18,23 while the remaining 9 focused on revision hip arthroscopic surgery. 1,7,[10][11][12]21,22,26,27 Patient Characteristics and Quality of Included Studies A total of 4765 hips in 4316 patients were included in this study. Sex was included only in the number of hips operated on rather than patients as a whole in 1 study.…”

Section: Eligibilitymentioning

confidence: 99%

“…Four studies 1,21,23,26 included the diagnoses at the time of the index procedure for the patients who proceeded to undergo revision hip arthroscopic surgery (Table 4). Twelve (80%) of the studies included in this review reported the diagnoses before revision hip arthroscopic surgery (Table 5).…”

Section: Diagnoses and Operative Proceduresmentioning

confidence: 99%

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Outcomes of Revision Hip Arthroscopic Surgery: A Systematic Review and Meta-analysis

O’Connor

Padaki

et al. 2019

Am J Sports Med

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Background: While the indications for primary hip arthroscopic surgery in treating femoroacetabular abnormalities continue to be defined, the indications and outcomes for revision hip arthroscopic surgery remain ambiguous. However, revision hip arthroscopic surgery is performed in 5% to 14% of patients after their index procedure. While patient-reported outcomes (PROs) generally improve after revision procedures, the extent of their improvement is not well defined. Purpose: To determine the outcomes and efficacy of revision hip arthroscopic surgery in patients who remain symptomatic after their index procedure. Study Design: Meta-analysis and systematic review. Methods: The terms “hip arthroscopy,”“revisions,”“outcomes,” and “femoroacetabular impingement” were searched in PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. After screening, 15 studies were included for review. In addition to hip-specific metrics, functional outcome measures were included. Pooled estimates and 95% CIs were calculated using inverse variance methods. Results: A total of 4765 hips in 4316 patients were identified. The most common indication for revision surgery was inadequate bony resection during the index procedure. Meta-analysis showed that all PROs improved significantly from baseline to final follow-up after revision hip arthroscopic surgery. Notably, the modified Harris Hip Score (mHHS) increased a mean of 17.20 points after revision hip arthroscopic surgery, the Hip Outcome Score–Activities of Daily Living (HOS-ADL) improved by 13.98, and the visual analog scale (VAS) for pain decreased by 3.16. However, when compared with primary hip arthroscopic surgery, the mean PRO scores after revision hip arthroscopic surgery were lower. After revision hip arthroscopic surgery, the rates of conversion to total hip arthroplasty ranged from 0% to 14.3%, and the rates of further arthroscopic revision ranged from 2% to 14%. Conclusion: Inadequate bony resection represents the most common indication for revision hip arthroscopic surgery. PROs improve significantly after revision hip arthroscopic surgery but remain lower than those of patients undergoing primary hip arthroscopic surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Eligibilitymentioning

confidence: 99%

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Outcomes of Revision Hip Arthroscopic Surgery: A Systematic Review and Meta-analysis

O’Connor

Padaki

et al. 2019

Am J Sports Med

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“…Additionally, at final follow-up, the average mHHS in our cohort was 76.8, which is similar to the value of 74.61 reported in the results of a meta-analysis on RHA by O'Connor et al 21 Of note, our cohort's average NAHS at final follow-up was 80.1, within the range of values reported in the literature on RHA (69.00-83.70). 22,23 These results suggest that RHA generally has positive implications for patients.…”

Section: Discussionmentioning

confidence: 79%

Radiographic Factors Associated With Failure of Revision Hip Arthroscopy

Bloom¹,

Yu²,

Kingery³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To identify clinical and radiographic factors associated with failure of revision hip arthroscopy (RHA). Methods A database was used to identify patients who underwent primary hip arthroscopy and revision hip arthroscopy (RHA) from January 2007 to December 2017 for the indication of femoroacetabular impingement and failure of the index procedure, respectively. The primary outcome was defined as the change, or difference, in the preoperative to postoperative alpha angle between patients with successful RHA and those with failed RHA. Failure was defined as reoperation on the operative hip for any indication or a modified Harris Hip Score (mHHS) of less than 70 at the 1-year postoperative time point. All patients had a minimum of 2 years’ follow-up from the date of revision hip surgery. Patients with a history of revision were divided into those with failed revisions and those with successful revisions. The inclusion criteria for failed revision included a history of subsequent revision surgery (or arthroplasty) or an mHHS of less than 70 at final follow-up. Results The study included 26 patients, comprising 8 (31%) with failed RHA and 18 (69%) with successful revision. The failure group showed a significantly smaller decrease in the alpha angle with surgery, measured on the Dunn view, compared with the success group. When the preoperative alpha angle was held constant, each 1° increase in the difference between the preoperative and postoperative alpha angles achieved during surgery was associated with a 17% decrease in the odds of failure. Patients included in the success group had both a higher preoperative mHHS (44.2 ± 8.6 vs 34.7 ± 9.6) and a higher postoperative mHHS (83.2 ± 8.3 vs 62.3 ± 14.2) than patients with failed RHA. There was a statistically significant difference in the frequency of patients who achieved the patient acceptable symptomatic state of +74.0 between the failure (25%) and success (83%) groups; 88% of patients in the failure group met the minimal clinically important difference, whereas 100% of patients in the success group (n = 18) met it. Conclusions Complete resection of cam lesions as determined by changes in the alpha angle, anterior offset, and head-neck ratio when measured on the Dunn 45° view correlates with positive clinical outcomes after RHA. Level of Evidence III, Retrospective Comparative Study.

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“…L'analyse du taux de réintervention après la réalisation d'une chirurgie arthroscopie itérative dans la littérature permet selon nous de bien exposer les difficultés de cette technique. Elle s'explique principalement par la difficulté d'évaluation de la résection comparativement aux chirurgies à ciel ouvert [26][27][28][29][30].…”

Section: Discussionunclassified

Traitement des conflits fémoro-acétabulaires par arthroscopie versus mini voie d’abord antérieure : étude cas témoin d’une série continue de 91 cas avec un suivi moyen de 4,6 ans

Martinot

Trouillez

Dartus

et al. 2020

Revue de Chirurgie Orthopédique et Traumatologique

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Reasons for and functional results of repeated hip arthroscopy: A continuous prospective study of 17 revisions out of 295 primary hip arthroscopies at mean 28 months’ follow-up

Abstract: Although less good than on primary arthroscopy, functional results on repeated hip arthroscopy were satisfactory in the short term. The main reason for repeated arthroscopy was persistence of initial abnormality due to insufficient treatment.

Cited by 8 publications

References 36 publications

Outcomes of Revision Hip Arthroscopic Surgery: A Systematic Review and Meta-analysis

Outcomes of Revision Hip Arthroscopic Surgery: A Systematic Review and Meta-analysis

Radiographic Factors Associated With Failure of Revision Hip Arthroscopy

Traitement des conflits fémoro-acétabulaires par arthroscopie versus mini voie d’abord antérieure : étude cas témoin d’une série continue de 91 cas avec un suivi moyen de 4,6 ans

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